Posted on 03/26/2008 6:08:06 AM PDT by wagglebee
Editor's note: The following commentary from Alex Schadenberg comes in response to a study in the Netherlands which found that 1,800 people - 7.1 percent of all deaths in the Netherlands in 2005 - were drugged into so-called continuous deep sedation shortly before dying. This compares with 5.6 percent of cases in 2001. At the same time, the use of euthanasia fell from 2.6 percent of all deaths to 1.7 percent, representing a decrease of 1,200 cases.
The question of the use of deep sedation in the Netherlands as the alternative form of euthanasia is an important question.
In the case of deep sedation, a person is usually sedated and then fluids and food are withdrawn, resulting in an intentional death by dehydration or "slow euthanasia."
Intentionally killing someone by injection (or as Dignitas Clinic in Switzerland now does, with a plastic bag and helium) usually takes several minutes and usually not more than one hour.
To intentionally kill someone by dehydration usually takes 10 - 14 days.
The problem with the moral assessment of deep sedation is that not all acts of deep sedation are related to decisions to intentionally kill the person. Sometimes a person is very near to death and experiencing intractable pain. The person is sedated and dies within a few days. This is not euthanasia, but in fact good palliative care.
Deep sedation can also be used in other cases when someone is not near to death but also experiencing intractable pain. These people can be sedated for several days. Fluids and food, however, should be continued, and after the short period of time the person comes out of the sedated state. These people are sometimes relaxed from their time of sedation and can be effectively treated for pain and symptom management without re-sedating them.
The point is: deep sedation can be used as a form of "slow euthanasia" or it can be effectively used as a form of good palliative care.
We must point out that when deep sedation is used as a form of euthanasia, this is an abuse of medical ethics. Such sedation is often an imposed death, whereby the family is not informed that the reason for the deep sedation is to cause the death of their family member.
Like all acts of euthanasia, deep sedation can be abused and is a direct threat to the lives of the most vulnerable people in our society who are not given the care and respect that is due a human person.
However, the culture of death doesn't care about any of this.
Pro-Life Ping
Freepmail wagglebee to subscribe or unsubscribe from the moral absolutes ping list.
FreeRepublic moral absolutes keyword search
Ping
Horrific.
I just want to make some remarks so that people understand there is a difference between euthanasia and sedation.
When my husband died of cancer at home, his pain level was very very high, and over the previous month, his body had become accustomed to high levels of morphine and other pain relievers. I want to point out that he was still walking to the bathroom, with my son’s help, the day that he died, so he was not “overly” medicated.
He was unable to take any fluids or food, and he had torn out his PIC line by himself, and refused to have it reconnected, so he could not be given any fluids. His body was shutting down, he was dying, he was aware, he was still whispering to us, and the morphine did not completely relieve his pain, no matter how much he was given.
He was given palliative care to the best of medicine’s ability to do so even at the end. He received the last rites that last day, but could not take the host; he was able to respond to our priest, his friend. Nothing was withheld, he was simply unable to take anything and became uncomfortable when the fluids he had been given in the PIC line just accumulated and did not hydrate him. He was conscious until about the last hour.
People who have relatives dying on hospice should not fear genuine palliative care—not everyone is aware the last several days, and some final comas last several days to a week before the body completely shuts down and dies. People often refuse — as opposed to having withheld — food and water when they are dying. You cannot force a dying person to eat, and often fluids simply stay in the location of the IV or PIC and do not circulate.
My father, when he died, was in a coma for a day before his death. He was in the hospital in ICU so he received every kind of care that could be given. It didn’t make any difference, except that he had a lot more pain than my husband did, and was very clearly unhappy about it.
When my mother died of cancer 35 years ago, she was in a coma for a week before she died. Her death was peaceful, but she had it in her stomach, so there was no question of her getting anything by mouth. Her IV infiltrated, and was not able to be started again due to her extreme weight loss from the disease, and she did not indicate discomfort in any way, just was “asleep” and barely breathing for a week.
People die in different ways. Moistening the lips, using IVs or PIC lines when they function are fine, pain relief is mandatory in my nursing experience, and people should not fear that they are “hastening” a loved one’s death by giving all that is necessary for the dignity of the dying person.
I say all this to say that death varies from person to person, depending on the cause, and that people who are dying often refuse what they genuinely do not want. Deep sedation, and withholding of food and fluids are both wrong, but at the very end, the doctor and other caregivers must accept the inevitable and do what is most comfortable for the dying person.
I’m not re-reading this before I post, so I hope there are no errors. If so, oh well. Death comes to us all. Sometimes, pain relief, like morphine, can shorten someone’s life beyond what medical science could sustain. When there is no use in doing that, then pain relief should take precedence, in my humble opinion.
Thank you for your thoughtful post. Very true.
As the author of this commentary noted, I recognize the difference between deep sedation and euthanasia. I too believe that sedation is a very humane and effective method to treat intense pain. However, when sedation is used as a means to starve and dehydrate the patient it is wrong and that is what the author was warning against.
My concern is for people who have suffered through the death of loved ones, that they have no guilt about pain relief; what could be more important?
That said, the subject of the article DOES sound like “slow euthanasia.” But each “case” is in reality a human being: one deserving of comfort, dignity, and the wishes of the dying. There is not one-size-fits-all and any attempt to legislate palliation is grotesque.
No errors, just a truckload of sense and compassion. God bless!
Understood, and I took it the way it was meant. Just wanted to caution against legislation of palliation.
Thank you. This issue is too deeply personal for it to be a political issue.
*********************
Agreed. Also, imho, denying pain relief is cruel and pointless. It's difficult enough to cope with the loss of a loved one without having to bear the thought that their final days were in agony.
No, to deny someone available palliative measures to minimize pain would be sinfully cruel.
I know that you have real and deep understanding of the issues....that your concern is that there never be another Terri Schiavo....and I love you for that.
My post was only meant to comfort those who have lost a loved one, and to prevent guilt at easing final agony.
I would also prefer my pain alleviated, even if it risks shortening my life. If I had reason to want to be awake (to visit with someone, say things needing to be said) and was willing to deal with the pain, then that's cool too.
But how sad it would be to deny pain relief for a dying person solely in order to make sure you aren't risking their life. What kind of life is that??
I am deeply concerned because there is about to be another Terri in Delaware. Her name is Lauren Richardson and her divorced parents disagree on what to do. Her mother wants to starve her and has even hired one of the lawyers who helped kill Terri.
http://www.freerepublic.com/focus/f-news/1964275/posts
Yes, I’ve been following that case.
My husband and I have had conversations between ourselves and also with my parents (who we would bear the brunt of decision-making for) trying to work out what we feel comfortable with as far as end-of-life decisions. We came to the conclusion that written directives may not fully address the situation a loved one is in.
My mother said, "I don't think I want to starve to death. But maybe the alternative is worse? Make whatever decision you can best live with."
And that's really all that we can do.
Disclaimer: Opinions posted on Free Republic are those of the individual posters and do not necessarily represent the opinion of Free Republic or its management. All materials posted herein are protected by copyright law and the exemption for fair use of copyrighted works.